The canadian experience

American media commonly claim that sweeping health-care reform is impossible because there is so little support for government intervention in the U.S. health-care market.

Actually, Business Week summarized its 2005 poll in these terms: "67% of all Americans think it's a good idea to guarantee health care for all U.S. citizens, as Canada and Britain do, with just 27% dissenting."

The Canadian system's chief features are: a) free choice of doctors; b) coverage of all citizens; and c) elimination of most bureaucracy by having one state-level "single payer" instead of hundreds of insurers. And, contrary to myth, doctors and hospitals remain in private practice, with only the health insurance industry largely replaced by the single-payer system.

In fact, some doctors seem as eager to see a fundamental shift toward single-payer as ordinary citizens. A Minnesota Medical Society poll released in February 2007 showed that 64% of doctors there explicitly support a single-payer plan.

Finally, while Americans are subjected to horror stories about Canadians flooding into the U.S. to escape long waiting lines for routine procedures, the respected journal Health Affairs found in 2002 that 40% of U.S. hospitals and clinics near the border had treated no Canadians; another 40% averaged less than one U.S. patient per month.

That is not to say the Canadian system has no problems. Pressure from conservatives resulted in sharp spending cutbacks on health care in the 1990s, causing a public backlash. Canadian hospitals also tend to run at very high capacity, and cutting-edge technological equipment is not quite as widespread.

But after looking across the border to the U.S. - where costs are nearly double, health outcomes are substantially worse, patient stays are much briefer because of pressure from insurers, and HMOs limit choice of doctors - few Canadians would trade their system for the one in the U.S.

Polls show 85% to 95% of Canadians express a preference for their own system; just 3% say that they would favor the U.S. model.

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